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Relationship With Nutrition, Food Security, Physical Activity, and Health Care Access

Ulfat Shaikh, MD, MPH; Robert S. Byrd, MD, MPH; Peggy Auinger, MS

Arch Pediatr Adolesc Med. 2009;163(2):150-157.

Objective  To determine if vitamin and mineral supplement use among children and adolescents in the United States is associated with nutrition, food security, physical activity, and health care access.

Design  Secondary analysis of nationally representative data from the 1999-2004 National Health and Nutrition Examination Survey.

Setting  Questionnaires, household interviews, and medical examinations.

Participants  Children and adolescents 2 to 17 years of age (N = 10 828).

Main Exposure  Vitamin and mineral supplement use in the past month.

Main Outcome Measures  Demographics, nutrition, food security, physical activity, and health care access.

Results  Approximately 34% (SE 1.2) used vitamin and mineral supplements in the past month, with underweight subjects reporting greater intake. Younger age, non-Hispanic white race/ethnicity, being born in the United States, higher milk intake, lower total fat and cholesterol intake, higher dietary fiber intake, higher income, greater food security, lower media/computer use, greater physical activity, lower body mass index, health insurance coverage, better health care access, and better self-reported health were associated with greater use of vitamin and mineral supplements. Such supplements contributed significantly to total daily dietary intakes of vitamins and minerals.

Conclusions  A large number of US children and adolescents use vitamin and mineral supplements, which for most may not be medically indicated. Such supplements contribute significantly to total dietary intakes of vitamins and minerals, and studies of nutrition should include their assessment. Since vitamin and mineral supplement users report greater health care access, health care providers may be in a position to provide screening and counseling regarding dietary adequacy and indications for supplement use.

Author Affiliations: University of California Davis School of Medicine, Sacramento (Drs Shaikh and Byrd); and University of Rochester School of Medicine and Dentistry, Rochester, NY (Ms Auinger).

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